For Physicians, Burnout Is the Constant Wave | Amid fears of a second wave for patients, COVID-19 has brought exponential stress to physicians from private practice to hospital settings. A recent study by University of California at San Francisco, showed rising levels of anxiety and emotional exhaustion, regardless of the intensity of the local surge.
In the first known study to assess stress levels of U.S. physicians during the coronavirus pandemic, doctors reported moderate to severe levels of anxiety at both work and home, including worry about exposing relatives and friends to the virus. Among the 426 emergency physicians surveyed, most reported changes in behavior toward family and friends, especially decreased signs of affection.
“Occupational exposure has changed the vast majority of physicians’ behavior at both work and home,” said lead author Robert M. Rodriguez, MD, a professor of Emergency Medicine at UCSF. “At home, doctors are worried about exposing family members or roommates, possibly needing to self-quarantine, and the effects of excess social isolation because of their work on the front line.”
The results featured in the “Academic Emergency Medicine”, found slight differences between men and women, with women reporting higher stress. Among male physicians, the median reported effect of the pandemic on both work and home stress levels was 5 on a scale of 1 to 7 (1=not at all, 4=somewhat, and 7=extremely). For women, the median was 6 in both areas. Both men and women also reported that levels of emotional exhaustion or burnout increased from a pre-pandemic median of 3 to a median of 4 after the pandemic started.
Lack of PPE was associated with the highest level of concern and was also the measure most often cited that would provide greatest relief. The doctors also voiced anxiety about inadequate rapid diagnostic testing, the risk of community spread by discharged patients, and the well-being of coworkers diagnosed with COVID-19.
But the survey also showed clear-cut ways of mitigating anxiety:
- Improve access to PPE;
- Increase availability of rapid turnaround testing;
- Clearly communicate COVID-19 protocol changes;
- Assure access to self-testing and personal leave for front line providers.
“This suggests that the impact of COVID-19 on anxiety levels is pervasive and that measures to mitigate stress should be enacted universally,” Rodriguez said. “Some of our findings may be intuitive, but this research provides a critical early template for the design and implementation of interventions that will address the mental health needs of emergency physicians in the COVID-19 pandemic era.”
So, what is LACMA doing about this sobering trend?
We launched the COVID-19 Rapid Response Initiative, the first medical society in the state to invest in PPE supplies, provide subsidies for struggling practices and technology assistance. A subsequent effort to help minority and women-owned practices were later deployed. The third step was the PPE Week where LACMA distributed $12 million in PPE over five days this past summer. While the three phases were historically impactful, a sustainable effort to distribute free PPE supplies going forward to address the #1 issue facing physicians (access to PPE) is critical. Therefore, the COVID-19 Rapid Response Maintenance Phase will kick off next month to provide practices free PPE supplies with members receiving a four-month supply and non-members receiving a two month supply to help weather the cold, flu and pandemic season. For the first time, LACMA has inventory, storage and a distribution program to help physicians facing this enormous challenge. Stay tuned for updates and instructions on how to receive your supplies.
Health Equity Takes Center Stage
The CMA House of Delegates voted this past weekend to edit the association's Articles of Incorporation and include in its mission statement an overarching permanent goal of achieving health equity and justice.
“CMA must adopt permanent institutions and institutionalized policies, practices and programs that promote, support and make actionable our aspirational principles on health equity and justice in order to eliminate health inequities that undermine our state’s public health and collective well-being,” said Robert Wailes, M.D., Chair of the CMA Board of Trustees.
CMA’s Board of Trustees also this year created a permanent committee—the Justice, Equity, Diversity and Inclusion (JEDI) committee—to ensure that CMA continues to consider its actions through a health equity lens similar to CMA's longstanding "public health" guiding principle. CMA’s new mission statement is now as follows:
“To promote the science and art of medicine, the care and well-being of patients, the protection of the public health, the betterment of the medical profession, and to achieve health equity and justice.”
LACMA launched the first Health Equity Council this past summer and continues to address parallel issues. Outcomes will be shared across our various platforms.
CMA's Young at Heart Award
CMA's Young Physicians Section presents the "Young at Heart" award to a deserving physician each year. Dr. Alex McDonald recognized Dr. Vito Imbasciani, California Department of Veterans Affairs Secretary, for his years of service to California's medical community.
With winter on its way, members can take advantage of our LACMA member deals, by clicking below:
2020 CMA Voting Guide | The November General Election is one week away! We hope that you will show up to the polls (or mail in your vote-by-mail ballot) and ensure the voices of physicians are heard loud and clear. Many counties recently changed their elections process under the “Voter’s Choice Act” and in response to the COVID-19 pandemic.
View your official CMA Voter Guide below to walk you through the process.
California Medical Association’s 2020 Legislative Wrap Up
As 2019 concluded, reasonable assumptions about 2020 began to emerge. The year was expected to be busy and more polarizing due to the presidential election occurring in November. Large-scale issue-based campaigns calling for new state programs supported by the expected state budget surplus were being announced. State legislators were finalizing their legislative packages. And lastly, the California Medical Association (CMA) was preparing to defeat yet another attempt to eliminate the cap on non-economic damages incorporated in California’s long-standing professional liability reform law, the Medical Injury Compensation Reform Act (MICRA).
Your Chance to Win PPE!
We are raffling off 2 boxes of PPE every 2 weeks until December 31, 2020. There will be 2 winners (every 2 weeks) and each box contains a 2 month supply of PPE valued at nearly $4,500.
Individual self-paying members are eligible for this raffle.
How to enter:
To be eligible for this raffle, simply renew your membership online or send in your renewal check in the mail and you will automatically be entered for the raffle drawing during that 2-week time frame. Please note that your name will be entered for only one raffle.
You will receive an email from Lisa Le informing you that you’ve won.
Email Lisa Le at email@example.com
Enter the current raffle now by clicking the renewal link below.
“Great works are performed, not by strength, but by perseverance.”
Chief Executive Officer
Los Angeles County Medical Association
“If it matters to our LACMA members, it matters to me.”